Political Activism

Part 1: In 500-750 words, address the following:

  1. Identify a current health care policy in your community or state.
  2. Research the issue and determine your personal stance based on the current evidence.

Part 2:

  1. Locate the contact information for a state, local, or federal official for your area.  – Florida State
  2. Locate information regarding the official’s stance on the issue. – Florida State
  3.  Send the official a letter or email that explains your position and offers suggestions on how the official should move forward with the agenda from your policy brief. – Please create a letter to the official as part of the assignment.

Answer

Political Activism

Health equity is an overarching goal of the federal and state healthcare system, especially considering the adverse consequences of health disparities. The Centers for Disease Control and Prevention [CDC] (2020) defines health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” Health disparities are inequitable and emanate from social determinants of health (SDOH), including socioeconomic status, access to nutritious food, physical activity opportunities, neighborhoods, built environment, and housing (Kleinman et al., 2021). These social determinants of health contribute to preventable disparities in care access, affordability, and utilization, prompting healthcare policymakers to implement policies that promote health equity.

At the federal level, the US government has enacted various landmark policies for promoting health equity by eliminating disparities in care access, affordability, and utilization. Examples of these policies are the Healthcare Quality Improvement Act of 1986 (HCQIA), Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act of 2010 (ACA). Florida has a policy for promoting health equity at the state level. The “Closing the Gap Act” promotes all-concerted efforts to eliminate racial and ethnic health disparities in the state. The primary strategy for eliminating ethnic health disparities in Florida is providing grants to stimulate the development and implementation of community-based and neighborhood-based projects to enhance positive outcomes among racial and ethnic groups.

The closing gap grant programs focus on various priority health areas and issues, including social determinants of health, sickle cell anemia, diabetes, cardiovascular diseases, cancer, HIV/AIDS, adult and child immunization, and maternal and infant mortality (Florida Department of Health, 2023). The state awards grants to eligible applicants, including persons, entities, or organizations within counties in Florida. The grant awarding criteria include matching funds requirements and performance-based allocations for multiple priority areas and focal priority populations. Finally, the policy seeks to strengthen the role of faith-based organizations in eliminating health disparities. Any person, entity, or organization in counties within Florida can apply for the closing the gap grant and coordinate project activities by developing partnerships requisite for implementing the grant and improving health outcomes.

Personal Stance Based on the Current Evidence

From a personal perspective, the closing the gap (GTG) grant policy reflects the state’s commitment to addressing health disparities and promoting health equity. Emphasizing partnerships between individuals, entities, and community-based organizations, including faith-based institutions, can impact large community sections, especially people grappling with ethnic disparities. Secondly, the performance-based allocation criterion can motivate eligible entities and communities to implement evidence-based practices and interventions for improving health outcomes and addressing the burden of various health issues, including cardiovascular diseases, diabetes, sickle cell anemia, and severe maternal morbidity.

Although the CTG program enshrined in the Closing the Gap Act can address health disparities in Florida counties by strengthening the resource and operational capacities of community-based organizations and partnerships, these strategies are deficient, considering the multifactorial nature of health disparities. According to Brown et al. (2019), health disparities persist due to the complex relationships involving socioeconomic, environmental, and system-level factors that account for the social determinants of health. Although ethnicity is one of the predictors of health inequalities, multiple other factors significantly influence care access, affordability, and utilization. These factors are educational attainment, housing, neighborhood environment, sociocultural predispositions, and food security. Therefore, addressing disparities that emanate from these social determinants of health requires evidence-based, system-level, and interdisciplinary interventions that extend beyond grant programs.

The current scholarly literature provides ideal recommendations for addressing health disparities and improving health equity. Garzon-Orjuela et al. (2020) identify some research-based strategies, including coordination among care providers, community mobilization, educational outreach programs, affordable insurance schemes, and improved health information systems. Similarly, Ghoman et al. (2020) propose incorporating remote health technology, including telehealth, as a profound intervention for addressing health disparities perpetuated by geographical and locational gaps. According to Ghoman et al. (2020), remote technologies like immersive healthcare simulation applications, e-learning resources, virtual reality programs, and digital simulators offer immediate and objective interpersonal communication and are ideal for promoting care continuity. They can reduce wait times and costs associated with in-hospital visits and improve care coordination. Therefore, I recommend that the Florida government consider incorporating the role of advanced technology in the Closing the Gap Act to bridge geographical gaps and associated factors that contribute to health disparities.

Part 2: An Official Letter Explaining My Position and Suggestions

Name

Address

Phone Number

Email

Date

Office of Governor Ron DeSantis

State of Florida

The Capitol

400 S. Monroe St.

Tallahassee, FL 32399-0001

(850) 717-9337

Dear Sir,

I wish to congratulate you and Florida State for the all-concerted efforts to address ethnic health disparities and promote health equity through the implementation of the Closing the Gap Act, which established a grant program (section 381.7356, Florida Statutes) for eligible individuals, entities, and organizations that spearhead targeted interventions. By focusing on priority areas like cancer, social determinants of health (SDOH), maternal morbidity, sickle cell anemia, diabetes, and cardiovascular diseases, addressing the risk factors and burdens associated with these conditions is significantly possible.

Although the Closing the Gap Act through the grant program significantly strengthens the role of community-based organizations and partnerships in addressing ethnic health disparities, the policy is deficient, considering the complex nature of social determinants of health (SDOH) contributing to preventable health disparities. It is vital to note that ethnicity is one of the non-modifiable determinants that exposes people to disparate access to quality care. However, this determinant relates to other underlying aspects, including low education attainment, income disparities, unfavorable neighborhood environments, deficiencies in built infrastructure, poor housing, and poverty. Therefore, the state should consider multifaceted, comprehensive, and interdisciplinary interventions for addressing health disparities and promoting health equity.

Some research-based recommendations for harnessing and improving the effectiveness of the Closing the Gap Act include incorporating advanced technologies like telemedicine in organizational practices, improving neighborhoods, educating community members to achieve health literacy, improving resource coordination, and offering cultural competency training to healthcare providers. The state will make the necessary steps to incorporate these recommendations in the current healthcare policies to ensure health equity.

Sincerely,

(Full Name)

References

Brown, A. F., Ma, G. X., Miranda, J., Eng, E., Castille, D., Brockie, T., Jones, P., Airhihenbuwa, C. O., Farhat, T., Zhu, L., & Trinh-Shevrin, C. (2019). Structural interventions to reduce and eliminate health disparities. American Journal of Public Health, 109(S1), S72–S78. https://doi.org/10.2105/ajph.2018.304844

Centers For Disease Control and Prevention. (2020, November 24). Health disparities. https://www.cdc.gov/healthyyouth/disparities/index.htm

Florida Department of Health. (2023). Closing the gap grant. https://www.floridahealth.gov/programs-and-services/minority-health/GrantFundingResources/closing-the-gap.html

Garzón-Orjuela, N., Samacá-Samacá, D. F., Luque Angulo, S. C., Mendes Abdala, C. V., Reveiz, L., & Eslava-Schmalbach, J. (2020). An overview of reviews on strategies to reduce health inequalities. International Journal for Equity in Health, 19(1). https://doi.org/10.1186/s12939-020-01299-w

Ghoman, S., Cutumisu, M., & Schmölzer, G. M. (2020). Using technology to bridge the gap for remote healthcare education during COVID-19. BMJ Simulation and Technology Enhanced Learning. https://doi.org/10.1136/bmjstel-2020-000733

Kleinman, D. V., Pronk, N., Gómez, C. A., Wrenn Gordon, G. L., Ochiai, E., Blakey, C., Johnson, A., & Brewer, K. H. (2021). Addressing health equity and social determinants of health through healthy people 2030. Journal of Public Health Management and Practice, Publish Ahead of Print (6). https://doi.org/10.1097/phh.0000000000001297

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